磁共振波谱在星形细胞瘤恶性程度分级及癫痫的应用

The Clinical Application of Magnetic Resonance Spectroscopy with Astrocytoma in Classification and Epilepsy

星形细胞瘤是神经上皮源性肿瘤中最常见的一类肿瘤。占颅内肿瘤的17%,占神经上皮源性肿瘤的40%,肿瘤向周围"蟹足样"浸润性生长,且无包膜形成。磁共振波谱(magnetic resonance spectroscopy,MRS)是随着磁共振成像(magnetic resonance imaging,MRI)发展起来的唯一的一种无创性研究活体组织的代谢情况和生化指标的技术,目前已在中枢神经系统疾病的临床工作和科学研究中得到广泛应用。它能活体检测脑组织,提供关于神经元功能、细胞能量代谢、细胞膜增殖和崩解以及选择性神经递质活动等信息,为脑肿瘤的临床治疗和科学研究提供了一条新的途径。磁共振波谱在星形细胞瘤的肿瘤实质区及肿瘤周围区的代谢物比值有助于肿瘤分级诊断,并且MRS有助于判定肿瘤的浸润边界,指导临床术中立体定位及组织病理学检查。此外,代谢-解剖叠加伪彩图体现的肿瘤本身的异质性在高低级别肿瘤中也有差异。近年来,许多学者研究发现磁共振波谱在星形细胞瘤患者有无癫痫发作者的代谢物水平不同,二者间的相关研究需要进一步深入。

Astrocytoma is the most common cancer in neural epithelial tumour,accounting for 17% of intracranial tumors,and accounting for 40% of neural epithelial tumour.The tumor growed like crab foot,surrounding normal tissue.MRS（magnetic resonance spectroscopy） originated from MRI（magnetic resonance imaging）,is the only non-invasive method to study the biochemical metabolism of living tissue,widely used in the diseases of central nervous system in clinical work and scientific research.MRS can detect the metabolism of brain tissue in vivo,providing the information of the neuronic function,cell energy metabolism,cell membrane multiplication and crumbling,and selective neurotransmitter activities.This is a new method of clinical study in brain tumors.The metabolite ratios of MRS in astrocytoma parenchyma and peritumoral edema regions contribute to tumor classification,and contribute to judging the tumor invasive border,to guide clinical intraoperative location and histopathological examination.Moreover,the heterogeneity of the cancer itself in high and low grade tumors also has differences.In recent years,many scholars＇ study found that the metabolite levels of MRS in astrocytoma are different between the patients who have seizures or not,and further relevant research was required.